Provider Demographics
NPI:1760045777
Name:BIRMAN, ANNA (MMS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:BIRMAN
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:MRS
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:VOLYANSKAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2627 NE 203RD ST STE 115
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1945
Mailing Address - Country:US
Mailing Address - Phone:305-699-5612
Mailing Address - Fax:
Practice Address - Street 1:2627 NE 203RD ST STE 115
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1945
Practice Address - Country:US
Practice Address - Phone:305-699-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113720363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant